WO1994009724A1 - Prothese a faible facteur de rigidite - Google Patents
Prothese a faible facteur de rigidite Download PDFInfo
- Publication number
- WO1994009724A1 WO1994009724A1 PCT/US1992/009004 US9209004W WO9409724A1 WO 1994009724 A1 WO1994009724 A1 WO 1994009724A1 US 9209004 W US9209004 W US 9209004W WO 9409724 A1 WO9409724 A1 WO 9409724A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- component
- prosthesis
- set forth
- bone
- stiffness
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/14—Macromolecular materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/389—Tibial components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
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- C—CHEMISTRY; METALLURGY
- C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
- C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
- C08L23/00—Compositions of homopolymers or copolymers of unsaturated aliphatic hydrocarbons having only one carbon-to-carbon double bond; Compositions of derivatives of such polymers
- C08L23/02—Compositions of homopolymers or copolymers of unsaturated aliphatic hydrocarbons having only one carbon-to-carbon double bond; Compositions of derivatives of such polymers not modified by chemical after-treatment
- C08L23/04—Homopolymers or copolymers of ethene
- C08L23/06—Polyethene
-
- C—CHEMISTRY; METALLURGY
- C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
- C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
- C08L71/00—Compositions of polyethers obtained by reactions forming an ether link in the main chain; Compositions of derivatives of such polymers
- C08L71/08—Polyethers derived from hydroxy compounds or from their metallic derivatives
- C08L71/10—Polyethers derived from hydroxy compounds or from their metallic derivatives from phenols
- C08L71/12—Polyphenylene oxides
-
- C—CHEMISTRY; METALLURGY
- C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
- C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
- C08L81/00—Compositions of macromolecular compounds obtained by reactions forming in the main chain of the macromolecule a linkage containing sulfur with or without nitrogen, oxygen or carbon only; Compositions of polysulfones; Compositions of derivatives of such polymers
- C08L81/06—Polysulfones; Polyethersulfones
Definitions
- This invention relate to an orthopaedic surgical implant device or prosthetic component useful for long-term replacement of an articulating surface in a joint.
- the articulating or bearing surfaces of bones in a joint are particularly susceptible to deterioration caused by injury or disease which leads to loss of movement and severe pain,. It is generally known to surgically remove the damaged bone in a joint and attach a prosthetic component onto the resected bone surface wherein the component is anatomically designed to closely replicate the natural form and function of the articulating surface.
- Total knee arthroplasty is a surgical procedure wherein the damaged bone surfaces of the knee joint are removed and replaced with implant devices which facilitate accurate articulation at the restored joint so that a full range of motion including extension, flexion and some rotation in the joint is possible.
- implant devices which facilitate accurate articulation at the restored joint so that a full range of motion including extension, flexion and some rotation in the joint is possible.
- a separate component for the femur, tibia and patella corresponding in configuration to the natural articulating surface of the bones respectively is provided.
- the metallic component is directly attached to the resected bone surface by a variety of methods.
- a plastic component is provided at the interface of the metallic surfaces to lower friction.
- the patellar and tibial devices are metal-backed plastic components.
- the metallic surface of the component is attached directly onto the bone surface and distributes load onto the related bone.
- the low-friction plastic surface provides the bearing or articulation surface in contact with the other surfaces in the joint.
- the femoral component is a single metallic unit having a full range of motion in contact with the plastic bearing surfaces of the tibial and patellar components.
- Each implant device has screws, pegs, stems or other contrivance to aid in the fixation of the device to bone on a short-term or long-term basis. It is additionally known to secure the compo ⁇ nents to the bone with cement applied at the interface of the bone and prosthetic component. Newer art provides a means for firm attachment to the bone in the form of porous metallic or plastic coating on the attachment surface of the component which permits bone ingrowth.
- tibial component designs have been developed to prevent loosening and component failure. More severe or harsh methods of attachment such as attaching the component onto the proximal end of the tibia with large spikes or posts have been used alone or in conjunction with cement. These designs are directed to preventing lateral or rotational movement of the component which may cause loosening over time. However, a large amount of bone must be removed to provide deep canals in the bone surface for spikes or posts.
- U.S Patent No. 4,808,185 to Penenberg, et al. discloses a tibial prosthesis developed to permanently fix the component to the bone.
- the distal surface of the implant device has domical contours which interengage and fit into corresponding domical recesses cut in the resected surface of the bone. Attachment is provided by screws placed through the component and into the proximal tibia at the domical recesses.
- a metallic coating as heretofore mentioned is also provided on the distal surface of the component to promote bone ingrowth.
- the component is designed to assure firm attachment to the bone by uniformly spreading forces through the tibia and preventing lateral movement of the component.
- the prior art means have attempted to solve the problem of component failure by firmly attaching the component to bone, evenly distributing load across the surface of bone and preventing lateral or rotational movement of the component.
- component loosening remains a problem, especially in the tibial replacements and further refinement is needed to improve implant longevity. In so doing the procedure could be offered to younger or more active patients who are presently not considered good candidates for TKA
- bone remodeling which prevents the bone for supporting the prosthetic component or patient activity level.
- the bone to which the prosthesis is attached is not a structurally homogeneous material, it has a wide range of mechanical properties.
- Bone has the ability to rearrange its entire structure in a pattern which will provide maximum strength while using a minimum of material. The resorption of old bone and generation of new bone occurs in a way which improves bone's ability to carry mechanical loads.
- Many of the design features incorporat- ed in the tibial components including attachment means such as pegs and stems deleteriously alter the manner in which mechanical load is distributed.
- the relatively stiff implant devices of the prior art distribute load to the underlying bone differently than it is transferred by the natural bone. In the natural tibia, loads are transferred throughout the two condyles of the femur, to the medial and lateral regions on the tibial plateau.
- cobalt-chrome and titanium which are typically used for orthopedic implants have a modulus of elasticity of 200,000 Newtons per millimeters square (N/mm 2 ) and 110,000 N/mm 2 respectively.
- the densest cancellous bone in the proximal tibia is 350 N/mm 2 , nearly three orders of magnitude less stiff than either of the metals.
- the mechanical stress and strain of the applied load at the flat interface of the component and proximal tibia causes abnormal bone growth and detrimentally affects the load carrying capability of the surrounding bone in the long term implant situation. Addition- ally, shear and tensile stress is experienced at the flat plateau interface of the proximal tibia which prevents biologic attachment of the component through bone ingrowth.
- an orthopaedic implant device designed to replace an articulating surface in a joint, wherein the device has a low stiffness factor which is capable of applying normal physiological load onto the underlying bone.
- the component is made of a material having a bulk modulus of elasticity nearer in magnitude to that of the underlying bone than has been that of previous components.
- the component will be manufactured from materials two orders of magnitude less stiff than high-strength metallic materials such as cobalt-chrome or titanium.
- the component is preferably made from an advanced material such as polyetheretherketone, polysulfone or ultra-high molecular weight polyethylene (UHMPE).
- UHMPE ultra-high molecular weight polyethylene
- a low-stiffness factor is also achieved by a relatively thin component.
- the device is provided with curvature to minimize bending stress in the relatively thin component so that the component has sufficient mechanical strength to prevent stress induced failure.
- the curved configuration additionally provides a component having relatively low shear stress at the interface of the device and the bone
- a tibial implant device made in accordance with the present invention is a bicondylar concave-shaped unitary component made of an advanced material and having a related cross-sectional thickness that defines a normalized stiffness of less than 50,000 Newtons per millimeter which is more commonly expressed as 50,000 N/mm.
- the upper surface of the component is generally concave-shaped and designed in conjunction with the femur or femoral implant to provide normal knee flexion and extension.
- the distal surface of the component is generally parallel to the upper surface, providing domical configurations on the distal surface in the medial and lateral regions of the component.
- Corresponding concave recesses in the proximal tibial bone surface are provided which receive the domical configurations on the distal surface of the implant when attached to the bone.
- Pegs or screws may be provided at the mid- sagittal region of the component to provide short term attachment.
- a porous thermoplastic coating on the distal surface of the component is preferred to promote bone ingrowth for long-term attachment.
- Fig. 1 is an exploded perspective view of a tibial prosthesis of this invention attached to cover the resected surface of the proximal end of a prepared tibia.
- Fig. 2 is a perspective view of the tibial prosthesis of Fig. 1 but shown in an inverted position to reveal details of construction;
- Fig. 3 is a top plan view of the tibial prosthesis of Figs. 1 and 2.
- Fig. 4 is a detailed cross-sectional view taken along line 4-4 of Fig. 3, the prosthesis being shown attached to the resected surface of the proximal end of a tibia forming a part of a prepared human knee joint shown fragmentally in broken lines; and Fig. 5 is a view similar to Fig. 4 but taken along line 5-5 of Fig. 3.
- a principal feature of the present invention is that the prosthetic component defines a stiffness as closely related as is reasonably possible to that of bone so that the component will transfer relatively normal physiological loading to the tibia.
- Mechanical analysis accessing the structural relationship of bones in the natural joint can be used to determine an upper limit on acceptable prosthesis stiffness for normal physiological load application.
- a useful tool for this mechanical analysis is a computer intensive mathematics modeling technique known as finite element analysis (FEA) which is commonly used to evaluate complex mechanical systems.
- FEA has been used to assess the structural relationship o f different tissues and the design of mechanical components used in prosthesis and fracture fixation. It is an outstanding tool for orthopaedic research because of its ability to handle irregular shapes and the intricate structural makeup of bone.
- the stiffness of a tibial implant should not exceed specified limits. This stiffness can be expressed as a combination of the bulk modulus of elasticity of the material used to fabricate the device and the cross- sectional thickness of the device.
- a line normal to the proximal and distal surface of the plate-like tibial device may be drawn and planes tangent to the surfaces at the intersection of the line with the surfaces are drawn.
- the elongation ( ⁇ ) of a plate defined by the planes heretofore described under a prescribed load is a function of plate geometry and the material from which it is made.
- ⁇ PL AE
- (P) is the force applied
- (L) is the length of the plate
- (A) is the cross- sectional area across which the load is applied
- E is a bulk modulus of elasticity of the plane in the direction of the length of the plate.
- This equation can be rearranged to describe the stiffness (K) of the plate in any direction.
- the cross-sectional area (A) of the plate is derived from the plate thickness t and the width b.
- any material having a bulk modulus of elasticity capable of defining a normalized stiffness of below 50,000 N/mm as heretofore defined and that is biocompatible can be used to fabricate the tibial component.
- Chromium cobalt and titanium materials are biocompatible and useful for surgical implantation, however, the modulus of elasticity for these materials is 200,000 N/mm 2 respectively. Accordingly, the preferred normalized stiffness is not easily attainable utilizing these materials, because the component would have to be extremely thin.
- there are many materials which do have a low modulus of elasticity other factors such as biocompatibility in particular limit the materials section.
- the implant device can be fabricated from advanced materials such as polysulfone and ultra-high molecular weight polyethylene which are currently utilized as low-friction bearing surface in prosthetic components and exhibit biocompatibility. These materials have shown utility as implant materials and are less stiff than the aforementioned metallic compounds.
- a preferred material is polyetheretherketone (PEEK) which is frequently available commercially from ICI Advanced Materials, Wilmington, DE. Although PEEK has not yet been approved for implant use, it is considered a good candidate.
- PEEK having a modulus of elasticity (E) of 3,600 N/mm 2 , provides a device having a normalized stiffness within the limit heretofore set and relatively close to the stiffness of bone.
- PEEK has outstanding material properties that make it desirable for use in prosthetic devices, including biocompatibility, resistance to a wide range of organic liquids and the capability of suffering no significant degradation in water environments. Additionally, this material has excellent creep, wear and abrasion resistance thereby providing a bearing surface having low friction for articulation with contacting bone, metal, or other plastic implants. By utilizing a low-friction material, a unitary component providing both a bearing surface and an attaching surface can be provided. The need for a two part tibial component is eliminated, although a two part component is not precluded if the combined stiffness of the components provides appropriate physiological load transfer to the underlying bone. PEEK is also preferred as a thermoplastic because it is processable by a wide range of conventional processes including injection molding.
- the PEEK material may be impregnated with glass and carbon fibers to form short and long fiber composite materials adding strength to the device. However, this also add stiffness to the device and the hydrolysis resistance and fatigue strength are somewhat diminished. Therefore, it is preferable to produce the device from PEEK that is not impregnated with such fibers. Rather, the necessary mechanical strength of the device is achieved by providing curvatures in the device. Although selecting a material with a relatively low bulk modulus of elasticity for the material used in fabricating the component significantly holds stiffness to a low level, the cross-sectional thickness of the component can also be reduced to further provide the relatively low stiffness factor required to achieve load application approximating that of the natural joint.
- the ability to reduce thickness of the component may be limited by the amount of bone mass removed, because a sufficient thickness is necessary to adequately replace the bone.
- the component should have a curved configuration so that a larger region of distributed contact stress is achieved and the bending stress in the component is minimized.
- the accompanying drawings illustrate a tibial component designated generally by the reference numeral 10 embodying the principles of this invention.
- the tibial component is a unitary plate-like component of relatively uniform thickness having a substantially C-shaped or kidney shaped configuration.
- the other periphery of the component corresponds generally to the outer periphery of the prepared proximal tibia 12, so that the tibial component covers nearly the entire proximal plateau of the surgically sectioned tibia.
- the proximal tibia is resectioned by known surgical methods to remove the damaged articulating surface of the bone and to provide a generally flat resected boner surface 14 for component attachment.
- Curved recesses 16 and 18 on the medial and lateral regions respectively of the tibia are surgically created by removing a small amount of bone from the resected bone surface.
- the configuration of these recesses corresponds with curvatures provided on the medial and lateral regions of the distal surface of the tibial component, to be described latter.
- the bone can be removed by any known methods, such as scraping with a convex tool.
- a lower limit to prosthesis stiffness is defined by the strength of the material of which the prosthesis is manufactured. Top prevent stress induced failures which accompany a low mechanical strength, curvatures which reduce bending stress are provided in the component.
- a significant portion of the mechanical stress in the tibial component stems from bending which can be greatly minimized by providing a device having concave curvatures 20 and 22 on the medial and lateral regions respectively of the proximal surface of the prosthesis as shown in Fig. 1.
- the distal surface of the prosthesis as shown in Fig. 2 is nearly parallel to the proximal surface forming domical related configurations 24 and 265 on the distal surface.
- the concave curvatures 20 and 22 provided in the proximal surface of the component correspond to receive the adjacent femural condyles as shown in Figures 4 and 5.
- the femural condyles represented as 30 and 32 interact and contact the proximal surface of the tibial component, rotating to simulate anatomical movement.
- the domical configurations 24 and 26 on the distal surface of the component fit correspondingly into the recesses 16 and 18 cut from the resected tibial surface. This reduces shear and tensile stress at the interface of the component and tibia and additionally promotes bone ingrowth where a porous coating as explained more fully hereinafter is applied to the distal surface of the component.
- the mid-sagittal region of the component is relatively flat having two holes 36 and 38 on the anterior and posterior region of the component respectively.
- Corresponding pegs or screws 40 are pressed or screwed through these holes into the proximal tibia surface to provide short term attachment of the component to the tibia.
- Short-term attachment of the concave-shaped tibial component to the bone can be accomplished by any other means which do not interfere with the long-term benefits provided by a prosthesis which is capable of proving normal physiological load transfer. This restriction will not necessarily preclude the use of any combination of pegs, posts or screws, however it is preferred that these devices not be used for attachment at the curved regions of the component.
- the porous coating can be produced by several known methods, and is preferably made of a thermoplastic such as the thermoplastic coatings described in U.S. Patent No. 4,164,794 issued to Spector et al. because of their relatively low stiffnesses as compared to wire mesh. It is conceivable that the entire compo ⁇ nent could be fabricated from a porous material into which bone may grow.
- the concave-shape is a more suitable configuration for biologic ingrowth because it reduces shear stress imparted to the interface. If the component is manufactured from advanced composite materials, fiber orientation can be arranged to further optimize this configuration.
- the general stiffness and transverse properties can be theoretically be tailored throughout the entire component to improve physiological load application and minimize shear stress at the bone interface.
- the concave shaped configuration does not however preclude the use of cement for long-term attachment, although biological bone ingrowth is preferred.
- the tibial component is a single unitary piece having a relatively uniform thickness.
- the component is made from a low friction material having a low bulk modulus of elasticity, thereby providing both a good bearing surface for interaction with the articulating surface of adjacent bones in the joint and also transferring loads more nearly approximating the transfer of loads in natural physiological joint load applications.
- the component is also preferably relatively thin to help achieve the desired low stiffness characteristic.
- the curved configurations of certain regions of the device reduce bending stress so that mechanical failure of the relatively thin component is lessened or avoided. Additionally, the curvatures reduce shear stress at the interface of the bone and prosthetic component.
- a tibial component embodying the principles of this invention can be formed by injection molding from polyetheretherketone (PEEK) provided by ICI Advanced Materials of Wilmington, Delaware. This material has a modulus of elasticity of about 3,6000 N/mm 2 . With a cross-sectional thickness of approximately 2.0 millimeters at the domical contours, a normalized stiffness (Kn) of the component in any radial direction around the concave-shaped surfaces is defined by Et which is about 7,200 N/mm. This stiffness nearly matches the normalized stiffness of subchondral bone.
- Subchondral bone is a thin layer of bone of the proximal tibia. It is approximately 1 mm. thick and has a modulus of elasticity of 7,000 N/mm 2 . Its normalized stiffness is therefore 7,000 N/mm.
- the concave curvatures reduce bending stress thereby permitting a relatively low thickness dimension while maintaining sufficient mechanical strength for the component. This component is considered entirely adequate for achieving the objectives of the invention as set out
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- Health & Medical Sciences (AREA)
- Chemical & Material Sciences (AREA)
- Medicinal Chemistry (AREA)
- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Veterinary Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Organic Chemistry (AREA)
- Polymers & Plastics (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Heart & Thoracic Surgery (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Physical Education & Sports Medicine (AREA)
- Dermatology (AREA)
- Epidemiology (AREA)
- Prostheses (AREA)
Abstract
Dispositif orthopédique (10) destiné à remplacer une surface articulaire dans une articulation (12). Ledit dispositif possède un facteur de rigidité relativement faible et est capable d'appliquer une charge physiologique normale sur l'os sous-jacent (14). On obtient un facteur de rigidité faible à l'aide d'un dispositif relativement mince constitué de matériaux qui présentent un module d'élasticité spatiale faible. Ledit dispositif présente des courbures (20, 22) destinées à réduire au minimum la contrainte de flexion à laquelle il est soumis, si bien qu'il possède suffisamment de résistance mécanique pour prévenir les problèmes induits par la contrainte.
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US07/873,631 US5176710A (en) | 1991-01-23 | 1992-04-20 | Prosthesis with low stiffness factor |
PCT/US1992/009004 WO1994009724A1 (fr) | 1992-04-20 | 1992-10-26 | Prothese a faible facteur de rigidite |
AU28985/92A AU2898592A (en) | 1992-04-20 | 1992-10-26 | Prosthesis with low stiffness factor |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US07/873,631 US5176710A (en) | 1991-01-23 | 1992-04-20 | Prosthesis with low stiffness factor |
PCT/US1992/009004 WO1994009724A1 (fr) | 1992-04-20 | 1992-10-26 | Prothese a faible facteur de rigidite |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1994009724A1 true WO1994009724A1 (fr) | 1994-05-11 |
Family
ID=26785117
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1992/009004 WO1994009724A1 (fr) | 1991-01-23 | 1992-10-26 | Prothese a faible facteur de rigidite |
Country Status (2)
Country | Link |
---|---|
US (1) | US5176710A (fr) |
WO (1) | WO1994009724A1 (fr) |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2000059411A1 (fr) * | 1999-04-02 | 2000-10-12 | Fell Barry M | Prothese de genou implantable chirurgicalement |
EP1568336A1 (fr) * | 2004-02-26 | 2005-08-31 | HJS Gelenk System GmbH | Remplacement d'articulation du plateau tibial |
CN102499795A (zh) * | 2011-11-10 | 2012-06-20 | 上海交通大学 | 具有弹性半月板功能的膝关节假体 |
Families Citing this family (75)
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US5192329A (en) * | 1991-03-07 | 1993-03-09 | Joint Medical Products Corporation | Oblong acetabular cup |
CH685669A5 (de) * | 1991-08-28 | 1995-09-15 | Sulzer Aktiengesellschaftprote | Kniegelenkprothese. |
CA2078840C (fr) * | 1991-09-24 | 1998-08-11 | Alan J. Yeadon | Prothese pour le poignet |
US5358529A (en) * | 1993-03-05 | 1994-10-25 | Smith & Nephew Richards Inc. | Plastic knee femoral implants |
DE4322619C1 (de) * | 1993-07-07 | 1994-09-22 | S & G Implants Gmbh | Tibiateil einer Kniegelenk-Endoprothese |
US5725573A (en) * | 1994-03-29 | 1998-03-10 | Southwest Research Institute | Medical implants made of metal alloys bearing cohesive diamond like carbon coatings |
US5605714A (en) * | 1994-03-29 | 1997-02-25 | Southwest Research Institute | Treatments to reduce thrombogeneticity in heart valves made from titanium and its alloys |
US5593719A (en) * | 1994-03-29 | 1997-01-14 | Southwest Research Institute | Treatments to reduce frictional wear between components made of ultra-high molecular weight polyethylene and metal alloys |
US6087025A (en) * | 1994-03-29 | 2000-07-11 | Southwest Research Institute | Application of diamond-like carbon coatings to cutting surfaces of metal cutting tools |
US5632745A (en) | 1995-02-07 | 1997-05-27 | R&D Biologicals, Inc. | Surgical implantation of cartilage repair unit |
US5769899A (en) * | 1994-08-12 | 1998-06-23 | Matrix Biotechnologies, Inc. | Cartilage repair unit |
US8603095B2 (en) | 1994-09-02 | 2013-12-10 | Puget Bio Ventures LLC | Apparatuses for femoral and tibial resection |
US6695848B2 (en) | 1994-09-02 | 2004-02-24 | Hudson Surgical Design, Inc. | Methods for femoral and tibial resection |
US5780119A (en) * | 1996-03-20 | 1998-07-14 | Southwest Research Institute | Treatments to reduce friction and wear on metal alloy components |
US5683466A (en) * | 1996-03-26 | 1997-11-04 | Vitale; Glenn C. | Joint surface replacement system |
DE29615920U1 (de) * | 1996-09-12 | 1998-01-15 | Waldemar Link GmbH & Co, 22339 Hamburg | Gelenkendoprothese |
US5928288A (en) * | 1998-05-13 | 1999-07-27 | Johnson & Johnson Professional, Inc. | Variable fit oblong acetabular prosthesis |
US6165223A (en) * | 1999-03-01 | 2000-12-26 | Biomet, Inc. | Floating bearing knee joint prosthesis with a fixed tibial post |
US6413279B1 (en) | 1999-03-01 | 2002-07-02 | Biomet, Inc. | Floating bearing knee joint prosthesis with a fixed tibial post |
US6972039B2 (en) | 1999-03-01 | 2005-12-06 | Biomet, Inc. | Floating bearing knee joint prosthesis with a fixed tibial post |
US20050209703A1 (en) * | 1999-04-02 | 2005-09-22 | Fell Barry M | Surgically implantable prosthetic system |
US6866684B2 (en) * | 1999-05-10 | 2005-03-15 | Barry M. Fell | Surgically implantable knee prosthesis having different tibial and femoral surface profiles |
US7338524B2 (en) * | 1999-05-10 | 2008-03-04 | Fell Barry M | Surgically implantable knee prosthesis |
US20050033424A1 (en) * | 1999-05-10 | 2005-02-10 | Fell Barry M. | Surgically implantable knee prosthesis |
US7491235B2 (en) * | 1999-05-10 | 2009-02-17 | Fell Barry M | Surgically implantable knee prosthesis |
US7297161B2 (en) * | 1999-05-10 | 2007-11-20 | Fell Barry M | Surgically implantable knee prosthesis |
US8062377B2 (en) * | 2001-03-05 | 2011-11-22 | Hudson Surgical Design, Inc. | Methods and apparatus for knee arthroplasty |
US6620199B2 (en) | 2001-07-13 | 2003-09-16 | Ronald P. Grelsamer | Device for reinforcing bone in partial knee replacement surgery |
US8388684B2 (en) | 2002-05-23 | 2013-03-05 | Pioneer Signal Technology, Inc. | Artificial disc device |
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